Clinical manifestations of patients with intraocular inflammation and positive QuantiFERON-TB gold in-tube test in a country nonendemic for tuberculosis

Am J Ophthalmol. 2014 Apr;157(4):754-61. doi: 10.1016/j.ajo.2013.11.013. Epub 2013 Nov 18.


Purpose: To evaluate clinical manifestations of patients with uveitis and scleritis of unknown origin and positive QuantiFERON-TB Gold In-Tube test (quantiferon) in a country not endemic for tuberculosis.

Design: Multicenter retrospective cohort study.

Methods: Retrospective review of the clinical, laboratory, and imaging data of 77 patients. Main outcome measures consisted of ocular and systemic features as well as results of laboratory examinations.

Results: Out of all, 60 of 71 (85%) were living for at least 6 months in tuberculosis-endemic regions. Location of uveitis was variable; posterior uveitis (29/77; 38%) was the most frequent. Two clinical entities were commonly noted: retinal occlusive vasculitis (21/77; 27%) and serpiginoid choroiditis (11/77; 14%). Antituberculosis treatment was completed in 32 patients; 29 of them (91%) achieved complete remission. Mean quantiferon level was 7.5 U/mL; 71% had values above 2 U/mL and 41% above 10 U/mL. We observed no associations between quantiferon levels and clinical and/or imaging features. Previous tuberculosis infection was diagnosed in 5 of 77 patients (6.5%), while hilar/mediastinal lymphadenopathy was found in 25 of 76 patients (33%). Of these, 12 were consistent with the diagnosis of sarcoidosis, 9 were typical for (prior) tuberculosis, and 4 were compatible with both diagnoses.

Conclusions: Ocular features of patients with idiopathic uveitis and positive quantiferon were diverse, but retinal occlusive vasculitis and serpiginoid choroiditis were common. The quantiferon levels were usually highly elevated and 33% of patients exhibited lymphadenopathy, suggesting frequently the diagnosis of sarcoidosis. Ocular inflammation reacted favorably to antituberculosis treatment, although only a small minority had documented (prior) tuberculosis.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antitubercular Agents / therapeutic use
  • Choroiditis / diagnosis*
  • Endemic Diseases
  • Female
  • Humans
  • Interferon-gamma Release Tests*
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Retinal Vasculitis / diagnosis*
  • Retrospective Studies
  • Scleritis / diagnosis*
  • Tomography, X-Ray Computed
  • Tuberculin Test
  • Tuberculosis, Ocular / diagnosis*
  • Tuberculosis, Ocular / drug therapy
  • Tuberculosis, Ocular / epidemiology
  • Uveitis / diagnosis*
  • Visual Acuity


  • Antitubercular Agents